Department of Clinical Laboratory, Guangzhou Women & Children Medical Center, Guangzhou Medical University, Guangzhou, China.
Am J Reprod Immunol. 2021 Jun;85(6):e13397. doi: 10.1111/aji.13397. Epub 2021 Feb 19.
Uteroplacental acute atherosis is a type of arterial vascular disease that affects the placenta during pregnancy and predominates in the maternal spiral arteries in the decidua basalis layer of the pregnant uterus. This condition is characterized by fibrin-like necrosis of the blood vessel walls, the accumulation of macrophages containing fat (foam cells), and the infiltration of macrophages around blood vessels. Uteroplacental acute atherosis is rare in normal pregnancy but occurs more frequently in patients with pregnancy complications, including preeclampsia, spontaneous preterm labor, preterm prelabor rupture of membranes, mid-trimester spontaneous abortion, fetal death, and small-for-gestational age. It is believed that the mechanisms underlying the development of uteroplacental acute atherosis are related to the incomplete physiological transformation of spiral arteries, placental inflammation, abnormal lipid metabolism, and oxidative stress. In this review, we describe the pathogenesis of uteroplacental acute atherosis to provide reference guidelines for the future prevention and treatment of uteroplacental acute atherosclerotic disease.
胎盘急性动脉粥样硬化是一种妊娠期间影响胎盘的动脉血管疾病,主要发生于妊娠子宫蜕膜基底蜕膜层的母体螺旋动脉。其特征为血管壁纤维蛋白样坏死、富含脂肪的巨噬细胞(泡沫细胞)积聚以及血管周围巨噬细胞浸润。胎盘急性动脉粥样硬化在正常妊娠中罕见,但在妊娠并发症患者中更为常见,包括子痫前期、自发性早产、胎膜早破早产、中孕期自然流产、胎儿死亡和胎儿生长受限。据信,胎盘急性动脉粥样硬化发展的机制与螺旋动脉的不完全生理性转变、胎盘炎症、脂质代谢异常和氧化应激有关。在本综述中,我们描述了胎盘急性动脉粥样硬化的发病机制,以期为未来预防和治疗胎盘急性动脉粥样硬化疾病提供参考指南。